Sleep as a Mediator Between Cannabis Use and Psychosis Vulnerability: A Longitudinal Cohort Study.

Objectives: Increasing evidence implicates cannabis consumption as a key risk factor in the development of psychosis, but the mechanisms underpinning this relationship remain understudied. This study proposes to determine whether sleep disruption acts as a mediator of the cannabis-to-psychosis relationship. Study Design: This longitudinal study assessed measures of cannabis use frequency, sleep quality (SQ), and psychotic-like experiences (PLEs) were collected using self-reported questionnaires. Data were collected from September 2012 to September 2018. Data were collected from a general population sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. The study uses data collected on an annual basis from 3801 high school students from grades 7 to 11. The aforementioned measures were measured using the Detection of Alcohol and Drug Problems in Adolescents questionnaire, a SQ Likert scale, and measures the Psychotic-Like Experiences Questionnaire for Children. Study Results: Results show a reciprocal 1-year cross-lagged effect of cannabis use and sleep (ß = -0.076, 95% CI = -0.037 to -0.018, P = .000), of sleep on cannabis use (ß = -.016, 95% CI = -0.025 to -0.006, P = .007), of sleep on PLEs (ß = -0.077, 95%CI = -0.014 to -0.051, P = .000), and of PLEs on sleep (ß = -0.027, 95% CI = -0.037 to -0.018, P = .000). We additionally found a 2 years indirect lagged-effect of cannabis use on PLEs (ß = 0.068, 95% CI = 0.024 to 0.113, P = .011) mediated by 1-year sleep (ß = 0.006, 95% CI = 0.003 to 0.009, P = .001). Conclusions: Our results suggest sleep disruptions simultaneously aggravate, and are aggravated by, cannabis addiction and PLEs. The longitudinal sleep-mediated effect of cannabis use on PLEs encourages further research into the role of sleep as a potential therapeutic target in the prevention of cannabis-related psychosis.

Development of the French version of the Davos Assessment of Cognitive Biases Scale in a non-clinical sample of young adults.

BACKGROUND: In accordance with continuum and cognitive behaviour models of psychosis, cognitive biases precede the onset and the maintenance of positive symptoms. The Davos Assessment of Cognitive Biases Scale (DACOBS), a self-report measure, was developed to explore the prevalence of specific cognitive biases. This study aims to validate the French version of this instrument. METHODS: We first translated the English version of the DACOBS into French. Then, using a sample of 213 French speaking young adults (mean age = 20.54, SD = 1.65; 83% females), we examined the factor structure, internal consistency, concurrent, and convergent validities of the current version. RESULTS: We found an 18-item, four-factor version of the French DACOBS comprising external attribution bias (five items), social cognition problems (five items), subjective cognition problems (five items), and safety behaviours (five items), provided best fit-to-data. Internal consistency for the resulting subscales ranged from acceptable to excellent (Cronbach's α range = .62-.86). All subscales were significantly, positively associated with a measure of psychotic-like experiences and positively associated with established measures of theoretically relevant constructs, demonstrating concurrent and convergent validity of the French DACOBS. CONCLUSIONS: The French DACOBS is a reliable and valid and reliable instrument assessing cognitive biases, in a French-speaking youth population. Ultimately, the French DACOBS may be used to identify at-risk youth which may benefit from cognitive interventions targeting cognitive biases, safety behaviours and social cognition which could potentially prevent transition to psychosis in youth.

Hazardous Drinking Mediates the Relation Between Externalizing Personality and Reduced Adherence to COVID-19 Public Health Guidelines in University Students.

Using a multigroup path analysis, we examined if hazardous alcohol use mediated the relations between elevated externalizing personality traits (i.e., impulsivity or sensation seeking) and reduced adherence to COVID-19 public health guidelines. We hypothesized that those high in externalizing personality traits would demonstrate less adherence to public health guidelines and that hazardous alcohol use would mediate this relationship. First- and second-year undergraduates (N = 1232; ages 18-25) from five Canadian universities participated in a cross-sectional survey between January to April 2021. Individuals with higher levels of impulsive or sensation seeking personality traits demonstrated poorer adherence to COVID-19 public health guidelines and these relations were mediated by hazardous alcohol use. Results suggest that hazardous drinking is an important target for students high in impulsivity and sensation seeking to increase their adherence to public health guidelines and thereby help control viral spread.

Pathways from adolescent screen time to eating related symptoms: a multilevel longitudinal mediation analysis through self-esteem.

OBJECTIVE: Screen time and self-esteem have been shown to be important correlates of eating disorders in adolescence. However, there is an absence of longitudinal studies that distinguish between time-varying factors, accounting for parallel developmental changes and common underlying vulnerability. DESIGN: A total of 3,801 adolescents were administered self-report measures, annually, over the course of 5 years. The association of screen time (social media use, television watching, video gaming) on eating related symptoms was analyzed using a longitudinal Bayesian multilevel path analysis framework. Self-esteem was examined as a mediating factor in this model. This study investigated direct and indirect associations at between-person, concurrent within-person, and lagged-within-person levels, while controlling for gender. RESULTS: The findings revealed that all types of screen time exposure were significantly associated with eating related symptoms at between and within-person levels. A significant association at the lagged-within person level was only revealed for social media use. Self-esteem was found to be a significant mediating factor between screen time and eating related symptoms. CONCLUSION: An increase in social media use one year was associated with increased of eating related symptoms two years later through lower self-esteem. Implications for prevention are discussed.

[The value of cognitive restructuring of reference ideas in schizophrenia]. / Intérêt de la restructuration cognitive des idées de référence dans la schizophrénie.

The process and results of cognitive restructuring of disabling reference ideas are presented through the study of a case of schizophrenia. The clinical evolution is measured according to an applied behavior analysis protocol that targets psychotic symptomatology and illness awareness. The results are encouraging since we observe a clinically significant decrease in the severity of reference ideas, anxiety and an improvement in illness awareness in only ten sessions.

The efficacy of a targeted PREVENTION programme for addictive behaviour (PREVENTURE) among vulnerable ADOlescents in France - study procotol.

BACKGROUND: Alcohol use is a major public health challenge in France, where at the age of 17 half the young people report an episode of severe alcohol intoxication in the month preceding the survey. Numerous prevention programmes have a general objective, but in adolescence individual vulnerabilities towards addictions differ significantly with personality traits. Prevention targeting personality traits enables work on risk factors for addictive behaviours, and has shown genuine efficacy. Among existing programmes, PREVENTURE has shown an effect on the reduction in alcohol consumption by targeting four personality traits: impulsivity, sensation-seeking, negative thoughts and anxiety. This programme has been tested on samples recruited in adolescent populations in school environments, identifying adolescents at risk, but it has not been tested on a more targeted recruitment of adolescents seen in consultation. METHODS: The main hypothesis of this study is that the targeted prevention programme PREVENTURE will have an impact on the prevalence of binge-drinking episodes. The secondary hypotheses explore other factors such as associated substance use, anxiety and depression, as well as the acceptability of the programme. This article presents the study protocol of "PREVADO" study. We intend to assess the impact of the targeted intervention programme PREVENTURE on the prevalence of binge-drinking episodes among adolescents aged 14 to 17 years consulting in one of the participating centres or referred by a school doctor. The study will be prospective, randomised, controlled and open-label, and will comprise an intervention group and a control group. The adolescents will then be followed and assessed 1, 3, 6 and 12 months after the intervention. The study needs to include 700 subjects in order to reach 340 adolescents randomised, 170 in each group. It will concern 33 centres. DISCUSSION: This project could favour the targeting of addictive behaviours among vulnerable adolescents, and its application on a larger scale could be envisaged. TRIAL REGISTRATION: The Trial registration number is NCT04599270 , and it was registered on the ClinicalTrials.gov public website.

Cognitive biases in individuals with psychotic-like experiences: A systematic review and a meta-analysis.

A prior meta-analyze using behavioral tasks demonstrated that individuals with subclinical delusional ideations jump to conclusion (JTC). The major aim of our systematic review and meta-analyses was to highlight the relationship between cognitive biases and psychotic-like experiences (PLEs) when both are assessed by self-reports measures. In accordance with PRISMA guidelines, four electronic databases were searched. A total of 669 studies were identified, 39 articles met inclusion criteria for the systematic review and 27 for the random effects meta-analysis on healthy and UHR samples investigating cognitive biases (JTC, aberrant salience (ASB), attention to threat (ATB), externalizing bias (ETB), belief inflexibility (BIB), personalizing bias, aggression bias and need for closure). Effect size estimates were calculated using Pearson's correlation coefficients (r). In samples including both healthy and Ultra High Risk (UHR) individuals, positive psychotic-like experiences (PPLEs) were positively associated with ATB (rs = 0.38), ETB (rs = 0.35), BIB (rs = 0.19), JTC (rs = 0.10), and personalizing (rs = 0.24). In community samples, PPLEs were positively associated with ASB (rs = 0.62), ATB (rs = 0.34), ETB (rs = 0.36), BIB (rs = 0.18), JTC (rs = 0.11). In addition, negative PLEs were positively associated with ATB (rs = 0.28), ETB (rs = 0.37), BIB (rs = 0.19) and ASB (rs = 0.18). In UHR samples, positive associations were established between PPLEs and ATB (rs = 0.47), ETB (rs = 0.34), personalizing (rs = 0.36) and the aggression bias (rs = 0.35). Our results support cognitive models of psychosis considering the role of cognitive biases in the onset and the maintenance of psychotic symptoms. Cognitive interventions targeting cognitive biases could potentially prevent transition to psychosis in youth reporting PLEs and in UHR.

[Cognitive Behavioral Therapies, a co-coconstruction of care]. / Les thérapies cognitives et comportementales, une coconstruction des soins.

The decline of the medical paternalism tend to promote the emergence of person centered approaches. Cognitive behavioral therapies allow the enhancement of empowerment and contribute to the expansion of experiential knowledge. Various therapeutic strategies are summarized as well as their benefits and especially their leading role in the generation of experiential knowledge.